Introducing Pedestrian Reflectors to Malawi

Road traffic injuries are the leading cause of death worldwide for young people between 15 and 25 years and among the top three causes of death for people aged between 5 and 44 years. Low- and middle-income countries have the highest burden: over 90% of all deaths globally due to road traffic accidents occur in countries where the majority of people walk and cycle to and from work or use overcrowded public transport means.

Many of the measures to reduce road traffic deaths and injuries are aimed at protecting car occupants. However, in Malawi, pedestrians and cyclists account for two-thirds of all road deaths. They too must be considered and given equal priority when policy decisions on road safety planning are made.

In 2010, six road traffic accidents on average were registered every day in Malawi. Three of these accidents involved a pedestrian, while one accident involved a bicyclist. Approximately 1,000 deaths were recorded the same year. The World Health Organisation (WHO) suspects that the true number of road deaths in most African countries is up to four times higher than the official numbers due to incomplete data recording. Under-reporting is influenced, for instance, by poor links between police, transport and health service data, which means that figures for people who die after admission to hospital may not be reflected. The extent of under-reporting is also influenced by the proportion of crashes involving vulnerable road users and the figures are suspected to be even more inaccurate for non-fatal injuries as they are less likely to be recorded. Studies have shown higher levels of under-reporting in data collected by the police and transport sector compared with countries where health sector data is also used, which suggests the need for closer links to improve data quality. If this is true in Malawi, there could be as many as 4,000 deaths due to road traffic accidents annually and a much larger number (8 to 40 times higher) being injured, many ending up with permanent disabilities.

In many countries, roads are planned and built to allow motor vehicles to travel faster and more smoothly, while insufficient thought is given to the needs of pedestrians and cyclists (lack of pavements, tarred foot and cycle paths and pedestrian crossings, for instance), which means that these vulnerable road users face increasing risks in using and crossing the roads. Of all the districts in Malawi in 2010, the highest number of road deaths was in Lilongwe. Most of the fatal accidents in Malawi occurred where the road was straight, tarred and in very good condition (without potholes) and because of over speeding. Vulnerable road users have a 90% chance of surviving a car crash at 30 km/h or below but less than a 50% chance of surviving impacts of 45 km/h or above.

The gradual upgrading of roads in Malawi has led to an increase in the speed motor vehicles travel at and to an ever-increasing rate and severity of accidents. Haukeland University Hospital (HUH) in Bergen, Norway, has been supporting Kamuzu Central Hospital in Lilongwe with surgeons, nurses and equipment since 2007 to help address this increasing burden of trauma and to train Malawian doctors to become surgeons. Despite improvements in the care of trauma victims at KCH in Lilongwe, the wards are full of traffic accident victims and it has become increasingly clear that there is a real need to face the problem and work on the prevention of road traffic accidents where pedestrians and cyclists are involved. Around 75% of the recorded road traffic accidents in Malawi happen in the dark or in the reduced light conditions at dusk or dawn. Most pedestrians are unaware of how difficult it is for the driver of a vehicle to see them in the dark. They are likely to think that, since they can see the lights of the car, the driver will also be able to see them. If a driver is driving at a speed of 80 km/h, he or she will only see a pedestrian one second before the car passes her/him. It does not give the driver time to react and it doesn't give the vulnerable road user much chance to survive. That is why HUH, KCH and the NRSCM have worked together to promote pedestrian and cyclist reflectors in Malawi. The programme is funded by a private company’s charitable foundation, The Rieber Foundation, in Bergen, Norway, and is also supported by the Norwegian Council for Road Safety. Through this cooperation, it has been possible to bring in 40,000 “slap-wrap” reflectors to Lilongwe in 2011 and the same is planned at least for 2012 and 2013.

The slap-wrap reflectors wrap themselves around your wrist or ankle and are made of high quality reflective material (CE EN 13356) that fulfils European regulations for visibility. For pedestrians, it is worn around the wrist closest to the road, normally the left wrist, as you should be walking on the right facing oncoming vehicles. For cyclists, the reflector will wrap around your right trouser leg at the ankle, which makes it more visible to drivers and even works as a trouser clip to help keep them clean and away from the chain. But car drivers remember: Reflectors do not work if you have not switched on your headlights! Switch on your headlights as soon as the sun is setting. Do not wait until it is nearly dark! Using your headlights even in the daytime has been shown to reduce the number of accidents significantly - and it does not wear out your battery.

Wearing a reflector in reduced light conditions reduces the chance of being run down by 85%. Our hope and goal is that after 3-5 years the idea should have caught on and sufficient awareness will have created a demand for reflectors. Hopefully, one will then see sustainable supplies of reflectors coming onto the Malawian market from organisations, government initiatives and possibly local businesses using reflectors in marketing.